HAROW: the first comprehensive prospective observational study comparing treatment options in localized prostate cancer

Abstract

Whereas RP remains the main treatment option of localized PCa, active surveillance appears to become an accepted and selectively employed treatment option. Careful selection of patients is documented by the highest proportion of patients with low risk (82.5 %), PSA density <0.2 ng/ml/ml (77.5 %), T1 staging (83.6 %), Gleason score ≤6 (92.5 %), ≤2 positive biopsies (79.4 %), and lowest mean PSA (5.8 ng/ml) in the AS group. The relatively high progression rate in the AS group has to be considered in the context of treatment changes; 71/155 patients had a documented change of treatment and 62 of them with a follow-up period of >3 months.

Active Surveillance for Incidental (cT1a/b) Prostate Cancer: Long-Term Outcomes of the Prospective Noninterventional HAROW Study

“…Discontinuation of AS was recommended in case of histological evidence of progressive disease, increasing PSA levels with PSA-DT <3 years, or clinical signs of progression on DRE, alternatively on patient’s request. Data of recruitment, diagnostics, and course of disease in the total cohort and the IPC cohort with a median observation period of 26.5 months have been published elsewhere [18, 19].…”

Risk stratification: a tool to predict the course of active surveillance for localized prostate cancer?

“…Initiated in 2008, the HAROW study was a prospective, non‐interventional, observational outcomes research study in the community setting , offering various treatment options to patients with localized PCa: hormone therapy (HT), AS, RT, RP or watchful waiting, with special interest in AS, at the time a relatively new non‐invasive therapy with curative intent. Upon signs of progression, patients were advised to opt for invasive therapy (RP or RT), or HT.…”

Long-term outcomes of active surveillance for clinically localized prostate cancer in a community-based setting: results from a prospective non-interventional study

“…Multiparametric magnetic resonance imaging (mpMRI) of the prostate was neither used nor recommended as it was not available at the time of recruitment. Data of recruitment, diagnostics, and course of disease in the total cohort for the study period with a median observation period of 28.4 months have been published elsewhere [9,10,14].…”

“…The HAROW study (2008-2013) is a prospective, multicenter, health service research study with the aim of investigating the treatment of localized PCa in the community setting in Germany [9]. The name represents the five possible treatment options: hormonal treatment (HT), AS, radiotherapy (RT), radical prostatectomy (OP = RP), and WW.…”